FINAL EXAM Flashcards
Personality Definition
Individual beliefs, traits, and actions
Personality Traits Definition
Enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts
Personality Disorder
Enduring pattern of inner experience and behavior that deviates from expectation of individual culture
Problems Diagnosing PD
Poor test-retest ability
Overlap between PDs
Sex and gender bias
5 Factor Dimensional Model
Extraversion, Agreeableness, Conscientiousness, Emotional Stability, Openness to Experience
Personality Cluster A
Odd or Eccentric = Paranoid, Schizoid, Schizotypal
Personality Cluster B
Dramatic, Emotional, Erratic = Antisocial, Borderline, Histrionic, Narcissistic
Personality Cluster C
Anxious or Fearful = Avoidant, Dependent, Obsessive-Compulsive
Paranoid PD
Pervasive, unjustified mistrust and suspicion of others. Hostility and jealousness
Paranoid PD Epidemiology, Etiology, Treatment
Epidemeology: Lifetime = 1% + More common in men
Etiology: cognitive early learning that the world is dangerous, and others are dangerous
Treatment: Need to develop trusting relationship + cognitive therapy focused on thinking about others
Schizoid PD
Pervasive pattern of detachment from social relationships
Schizoid PD Epidemiology, Etiology, Treatment
Epidemiology: Lifetime <1% + More common in men
Etiology: Social isolation resembles autism + cognitive “I am self-sufficient, and others are intrusive”
Treatment: Cognitive therapy to value interpersonal relationships and build empathy
Schizotypal PD
Odd and unusual behavior, thoughts, and appearance. Magical thinking and ideas of reference (hidden meaning)
Schizotypal PD Epidemiology, Etiology, Treatment
Epidemiology: lifetime 3% + increased risk of schizophrenia
Etiology: Phenotype of a schizophrenia genotype?
Treatment: Social skills training + antipsychotic medication + address comorbid depression
Antisocial PD
Noncompliance with social norms + violate the rights of others + lack empathy/remorse
Antisocial PD Epidemiology, Etiology, Treatment
Epidemiology: Lifetime 3% men 1% women
Etiology: Family factors + lack of affection + severe parental rejection + inconsistent discipline
Treatment: Poor prognosis + incarceration often the only viable alternative
Borderline PD
Pattern of unstable moods and relationships, fear of abandonment + impulsivity + poor self-imaging
Borderline PD Epidemiology, Etiology, Treatment
Epidemiology: Lifetime 1-2% + more common in women
Etiology: Genetics (runs in family) + early trauma and abuse (sexual or physical)
Treatment: Antidepressant meds + Dialectical BT to identify and regulate emotions, problem solving etc. (similar to PTSD therapy)
Histrionic PD
dramatic, attention-seeking, self-centered, provocative, shallow, impulsive
Histrionic PD Epidemiology, Etiology, Treatment
epidemiology: prev=2-3%, more common in women
etiology: unknown, sex-typed variant of antisocial PD
treatment: address long-term consequences of attention seeking and problematic interpersonal behaviors
Narcissistic PD
exaggerated self-importance, entitled, lack empathy, seek attention
Narcissistic PD Epidemiology, Etiology, Treatment
epidemiology: prev=<1%, more common in men, comorbid depression
etiology: failure to learn empathy, product of the “me” generation, think they are superior
treatment: address grandiosity, lack of empathy, comorbid depression
Avoidant PD
sensitivity to others opinions, avoid most interpersonal relationships, socially anxious, fear rejection
Avoidant PD Epidemiology, Etiology, Treatment
epidemiology: prev=1%
etiology: difficult temperament, early rejection
treatment: CBT (treat like social anxiety disorder), effective
Dependent PD
extreme dependence/over-reliance on others, passive/submissive, fear of abandonment, clingy
Dependent PD Epidemiology, Etiology, Treatment
epidemiology: prev=1.5%, more common in women
etiology: unknown, maybe early disruptions in attachment, feel completely helpless without person they depend on
treatment: goal=increased independence, lack outcome studies
Obsessive-Compulsive PD
perfectionistic; concern with routines, doing things “right” (different from OCD)
Obsessive-Compulsive PD Epidemiology, Etiology, Treatment
epidemiology: lifetime prev=1%
etiology: unknown, believe they must have control
treatment: cognitive therapy, relaxation distraction, lack outcome studies
Masters and Johnson
stages of sex are: desire, arousal (plateau), orgasm, resolution
Helen Kaplan
added the desire phase: phase before we begin cycle
Gender Dysphoria
When one’s gender differs from SAAB and causes distress
Basson Model
doesn’t differentiate between desire and arousal, feedback loop: more positive experience=more satisfaction=more intimacy=more positive response in the future
Primary Sex Characteristics
Internal and external genital expression (ex. PENIS 😂)
Secondary Sex Characteristics
Hormone activated characteristics (ex. BOOBS 😂)
Gender problems with DSM-5 and textbook
they’re heteronormative and only refer to the binary, not clear how they define “male” and “female”
Gender
Presentation or experience of masculinity, femininity, or androgyny
Criteria for sexual dysfunction
6 months, occur during 75-100% of partnered activity, distress for all, lifelong vs acquired, situational vs generalized, mild/moderate/severe
Gender Dysphoria Myths
Not all people want to change primary/secondary characteristics
Not all people operate on a binary
People who “detransition” are 82.5% likely to do so because of external rather than internal factors
Male Hypoactive Sexual Desire Disorder
persistently deficient sexual thoughts/fantasies, deficient desire for sexual activity
(not asexuality and needs to cause distress)
Female Sexual Interest/Arousal Disorder
lack of/reduced sexual interest/arousal (desire and during activity)
cons: muddles desire and arousal, relies on assumption that decreased interest in sex is abnormal (must cause distress)
Erectile Disorder
difficulty obtaining/maintaining erection, or boner not hard enough!
differential diagnosis: can be from using SSRIs or depression
Premature Ejaculation
person with penis ejaculating within 1 minute of penetration (heteronormative) or before they want to
Gender Dysphoria Treatment
Merge gender identity and gender expression in day-to-day life. Engage in gender exploration for about 6 months. Gender-affirming medical procedures.
Delayed Ejaculation
delay in ejaculation or infrequency during activity
Gender-affirming medical procedures
Taking estrogen or testosterone, removing primary/secondary characteristics (genital alteration must be approved by a therapist to be covered by insurance)
Psychotherapy
Normally just use some form of CBT
Female Orgasmic Disorder
marked delay, infrequency, absence of female orgasm
reduced intensity of female orgasm, some never orgasm
cons: this is dumb because orgasm isn’t all that matters, some people never orgasm and that’s ok, also why the sex distinction?
Gender Dysphoria DSM-5 Controversy
Some argue “disorder” label stigmatizes. Diagnosis often required for medical procedures. Gender dysphoria “goes away naturally”.
Paraphilia
Any intense and persistent sexual interest unrelated to genital stimulation or fondling with phenotypically “normal” human partners (mature)
Genito-Pelvic Pain/Penetration Disorder
pain during penetrative vaginal intercourse or any penetration (dysparenia)
fear/anxiety about pain of penetration causes pelvic floor to tense (vaginismus), causing the pain
(can occur outside of intercourse like at OBGYN, tampons)
define old
young-old: 55-64
middle-old: 65-74
old-old: 75+
defined by policy, not physical changes
Neurocognitive Disorder (dementia)
gradual deterioration of brain functioning in memory, judgment, language, cognitive processes, impulse control
Defining Paraphilia Disorder
MUST experience recurrent and intense sexual fantasies, urges, or behaviors surrounding non-genital stimulation.
-have a paraphilia
-experience distress
-experience impairment
-have engaged in non-consensual acts
–> MAJORITY of people with paraphilia would not meet criteria
Criteria for Neurocognitive Disorder
significant cognitive decline that interferes with independence and the ruling out of delirium and other disorders is required
Major vs mild Neurocognitive Disorder
significant vs mild cognitive decline and interferes with independence vs doesn’t
13 Neurocognitive subtypes: “due to”
Alzheimer’s, vascular disease, frontotemporal lobe degeneration, Lewy body disease, HIV, Parkinson’s, Huntington’s, traumatic brain injury, substance/medication, prion disease, another medical condition, multiple etiologies possible, or unspecified
Neurocognitive Disorder epidemiology
65+=5%
75+=10%
85+=20-40%
100+=100%
Paraphilia Categories
Non consent = voyeuristic (watching others), exhibitionistic (exposing in public), frotteuristic (rub on someone else), pedophile
Pain/Humiliation = Sexual masochism and sexual sadism
Fetishism = Sexual fetishistic, transvestic
Alzheimer’s Disease Requirements
requires genetic variant or multiple cognitive deficits, gradual/steady decline
autopsy required
early onset: 40s-50s
Alzheimer’s Symptoms
impaired memory, disorientation, narrowed interests, aphasia, apraxia, agnosia, executive functioning worse, agitation, confusion, depression, anxiety, combativeness
Alzheimer’s epidemiology
50% of major dementia
usually onset in 60s/70s
more common in women
high education delays onset
average survival=8 years
gradual, then rapid, then gradual to death
Delirium
Fluctuating consciousness from mental confusion to lucidness
-disorientation
-incoherent speech
-anxiety
-hallucinations
-nightmares
-delusions
–> rambling incoherent speech, very vivid visual hallucinations
–> REVERSIBLE AND TREATABLE
Alzheimer’s causes
neurobiological=
amyloid plaques: protein deposits attach to neurons, killing neurons
neurofibrillary tangles: tangled protein filaments
atrophy: wasting away of brain
genetic=
if you have gene Preseniln-1 or 2, you have the disorder
if you have apo E4 or APP (breaking down of protein) you are more susceptible
Delirium Etiology
-drug intoxication or withdrawal
-malnutrition
-metabolic imbalance
-infection/fever
-neurological disorder
-stress of surgery
Alzheimer’s treatment
no cure, but effective treatment
medical: Cholinesterase inhibitors that raise acetylcholine, Aducanumab to reduce amyloid plaques
psych: compensatory skills, cognitive stimulation, support from family
prevention: control blood pressure, reduce stress, exercise, don’t get head trauma, don’t do too many crazy drugs
Delirium Epidemiology
Rapid onset + rapid resolution with full recovery
Most common in older adults
core features of dissociative disorder
disruption in 1 or more:
consciousness, memory, identity, perception
Delirium Treatment
Identify and treat underlying conditions
-antipsychotic medications
-reassurance + support
-prevention
Dissociative types and symptoms
depersonalization: detached from self
derealization: unreality
amnesia: for personal info or time
identity confusion
identity alteration
dissociative amnesia
loss of autobiographical memory (from traumatic event) that typically remits abruptly and most get better without treatment
dissociative fugue
sudden, unexpected travel, amnesia, confusion with identity, distress, can last hours to months, full recovery, and single episode most common
dissociative identity disorder (DID)
2 or more personality states
memory gaps
inter-alter awareness: mutually amnesic, mutually cognizant, one-way amnesic
sudden switches between states (chill or dramatic)
alters differ in name, race, abilities, age, sexual orientation, preferences, sex, personality, psychophysiological responses
DID Epidemiology
Mean # of alters: 13
3-9x more common in women
Childhood onset
Abuse history
Chronic
DID Etiology
Posttraumatic model: very complex and extreme form of PTSD
sociocognitive model: DID results from media and therapist influences
DID Treatment
Good therapeutic relationship
Recover memory gaps between alters
Bring alters together
Depersonalization/Derealization Disorder
Aware that experience is happening and not real
Prevalence: 0.8-2.8
Mean age = 16
Chronic
Dissociative Disorders Etiology
Psychoanalytic: dissociation is extreme repression from unwanted experience
Behavioral: negative reinforcement maintains dissociation
Somatic Disorders Core Features
“soma” = body
preoccupation with body function
physical symptoms without medical explanation
WORRY
overuse medical services (9x more) which is issue in medical scene
Conversion Disorder
Originally Hysteria
1 or more sensory motor symptoms which are medically unexplained (ex. paralysis, blindness)
Not faking
Related to psychological factors
Somatic Symptom Disorder
One or more somatic symptoms with distress/impairment
Excessive with perceived seriousness, anxiety, and/or time + energy
Duration _> 6 months
Illness Anxiety Disorder (hypochondriasis)
Disease conviction of an often severe or deadly disease
Severe anxiety
Checking or avoiding
Medical reassurance only temporarily alleviates stress
_> 6 months
Differential Diagnosies
Malingering: Deliberately faking for some sort of gain
Factitious Disorder: crave attention by intentionally being sick
Factitious Disorder imposed on another: getting a loved one intentionally sick for self-gain
Somatic Disorders Etiology
Psychodynamic: primary gain repress conflict, secondary gain avoid responsibility
Behavioral: positively and negatively reinforced
Cognitive: misinterpret body sensations
Somatic Disorders Treatment
Lower medical visits
Gatekeeper physician
CBT: cognitive reconstructing, tell family and friends to ignore feeling bad for “sickness”
Stress management
